Shasta County residents die by gunfire at a rate nearly twice that of the average Californian and over a three-year period the county tallied more firearm-related deaths per capita than any other in the state, according to a report issued by the state Department of Public Health.

Released in April, the 2013 County Health Status Profiles report ranks counties based on how many people per 100,00 die of various maladies and conditions over a rolling three-year period.

The current report examined deaths from 2009 through 2011.

With a rate of 13.8, Shasta County was No. 1 in gun deaths, well above California's rate of 7.8. The county also topped the chronic lower respiratory diseases category with a rate of 71.5, nearly twice California's 37.5.

Trinity County had the highest rate of deaths from all cancers — 200.8, about 50 deaths higher than the California average.

Public health officials say Shasta County's high gun death rate represents the large number of suicides — Shasta County sees about 40 suicides a year, and statewide the county ranked second in suicides with a rate of 22.2 per 100,000.

Shasta County's death rate from all accidental injuries was 62.6. Its homicide rate was 2.6, although the state cautioned that number of homicides reported were too low to yield reliable data.

Simply having a gun is considered a risk factor for suicide, said Rebecca Carter, a psychology instructor at Simpson University and a licensed marriage and family therapist.

Men are also more likely to choose a firearm in suicide attempts.

"Generally, they are more familiar with firearms," Carter said. "In Shasta County, there are more firearms. The ability to have a firearm, for hunting or protection ... when they have access, that automatically exposes people to more lethal means of taking their own lives."

She said access to firearms goes beyond weapon ownership. Merely knowing a gun owner brings the weapons into proximity.

Gun store owner Patrick Jones said the prevalence of firearms leads to their use in suicides.

Nevertheless, he maintains guns aren't the issue.

"If people seek to commit suicide, there are multiple ways to do it. If they didn't have a firearm, they'd find another way," he said. "It could be hanging, standing in front of a train, overdosing."

Instead, mental health issues fuel the problem, he said.

While mental health remains at the core of suicide, the means does make a difference, said Stasia Pringle, who works on suicide prevention with the Shasta County Health and Human Services Agency. Guns are far more lethal than overdosing. And, while a person may spend a long time contemplating a suicide, once they make up their mind they usually don't delay. Then, they frequently regret their attempt.

If they don't get a chance to kill themselves, the suicidal feelings dissipate quickly, she said.

"The crisis will pass," Pringle said.

She said gun safety is the best way to help a person who may be contemplating suicide. A friend or family member getting the gun out of reach is the best option, but simply employing basic protections can help, she said.

"Safeguard lethal means — make sure guns are locked in a safe," she said.

Jones agreed, noting that every gun comes with at least one locking mechanism. He said such safety measures, including a lock that latches through the chamber and clip of the gun, have become much more commonplace.

While that helps prevent suicide, he said, it stems from a fear of the gun being stolen. He said he sells gun safes at a much higher rate than several years ago — at least one a day.

Shasta County last claimed the top spot among the firearm-related death rates in 2010's County Health Status Profiles with the same rate — 13.8 deaths per 100,000 people.

SUICIDE

"Shasta County isn't alone in higher suicide rates — all of Northern California has a higher rate compared to the state," Pringle said.

However, the number of suicides, gun deaths and other conditions were too low to reliably measure surrounding counties' death rates in many categories, according to the state.

Alcohol and drug abuse, depression, general anxiety disorder, and experiencing a recent loss in one's life are all risk factors for suicide, Carter said.

She said a person contemplating suicide often has relied on other coping mechanisms that no longer work. That creates a feeling of helplessness and hopelessness.

"They're just at a loss, and they don't know what to do," she said.

Jones said his gun store has to wait 10 days before handing over a gun to an individual, an ineffective "cooling off" period. He said other states manage to achieve lower suicide rates without the waiting period.

Someone can also fail a background check if it turns up that they were diagnosed with mental illness. That includes those experiencing depression or general anxiety disorder.

"It is worthwhile to keep firearms out of their hands at the time," Jones said.

Friends and family should also broach the subject of a person's mental health, although Carter acknowledged it would be an "awkward" conversation.

"By asking the question and putting it out there, you can relieve anxiety and worry from that person. They don't have to bring that up," she said. Even if they're rebuffed, they should stress their concern. "Just say, ‘I wanted to make sure you're OK.' It gives the opportunity to say that you matter. I think we all need to hear that from time to time."

OTHER DEATHS

Shasta County claimed the No. 1 spot in deaths from lower respiratory ailments, such as emphysema or chronic obstructive pulmonary disorder, largely because of the county's high smoking rate, said Nathan Read, HHSA's community education specialist with HHSA's tobacco education program.

"Smoking rates tend to be higher in rural communities and communities with higher rates of poverty," he said. "The rural and (impoverished) tend to be the population targeted most by advertising of the industry — they're also the most sensitive groups. We still have smokeless tobacco sponsorships at our rodeos up here."

Higher substance abuse rates also push up the number of smokers, Read said.

Between 19 percent and 24 percent of Shasta County residents smoke, compared with 13 percent for the state of California.